Gender violence, poverty and HIV infection risk among persons engaged in the sex industry: cross‐national analysis of the political economy of sex markets in 30 European and Central Asian countries

Reeves, Aaron; Steele, Sarah; Stuckler, David; Amato‐Gauci, Andrew J.; Semenza, Jan C.

doi:10.1111/hiv.12520

Cited by 10 publications

(2 citation statements)

References 35 publications

(58 reference statements)

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“…For instance, only about half of the countries in Europe and Central Asia offer HIV treatment to undocumented migrants . Other populations that are also likely to suffer differential provision of HIV health care services are sex workers and people who inject drugs . Consequently, our results are likely to be conservative estimates of the association between ART initiation policies and population‐level access to ART.…”

Section: Discussionmentioning

confidence: 99%

Population uptake and effectiveness of test‐and‐treat antiretroviral therapy guidelines for preventing the global spread of HIV: an ecological cross‐national analysis

Mendez‐Lopez

Stuckler

Granich³

et al. 2019

HIV Medicine

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Objectives Although the benefits of adopting test‐and‐treat antiretroviral therapy (ART) guidelines that recommend initiation of ART regardless of CD4 cell counts have been demonstrated at the individual level, there is uncertainty about how this translates to the population level. Here, we explored whether adopting ART guidelines recommending earlier treatment initiation improves population ART access and viral suppression and reduces overall disease transmission. Methods Data on ART initiation guidelines and treatment coverage, viral suppression, and HIV incidence from 37 European and Central Asian countries were collected from the European Centre for Disease Prevention and Control and the Global HIV Policy Watch and HIV 90‐90‐90 Watch databases. We used multivariate linear regression models to quantify the association of ART initiation guidelines with population ART access, viral suppression, and HIV incidence, adjusting for potential confounding factors. Results Test‐and‐treat policies were associated with 15.2 percentage points (pp) [95% confidence interval (CI) 0.8–29.6 pp; P = 0.039] greater treatment coverage (proportion of HIV‐positive people on ART) compared with countries with ART initiation at CD4 cell counts ≤ 350 cells/μL. The presence of test‐and‐treat policies was associated with 15.8 pp (95% CI 2.4–29.1 pp; P = 0.023) higher viral suppression rates (people on ART virally suppressed) compared with countries with treatment initiation at CD4 counts ≤ 350 cells/μL. ART initiation at CD4 counts ≤ 500 cells/μL did not significantly improve ART coverage compared to initiation at CD4 counts ≤ 350 cells/μL but achieved similar degrees of viral suppression as test‐and‐treat. Conclusions Test‐and‐treat was found to be associated with substantial improvements in population‐level access to ART and viral suppression, further strengthening evidence that rapid initiation of treatment will help curb the spread of HIV.

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Section: Discussionmentioning

confidence: 99%

Population uptake and effectiveness of test‐and‐treat antiretroviral therapy guidelines for preventing the global spread of HIV: an ecological cross‐national analysis

Mendez‐Lopez

Stuckler

Granich³

et al. 2019

HIV Medicine

Self Cite

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“…Refusing to use or removing condoms during sex by a paid or unpaid partner as well as diminished self-efficacy for condom negotiation among FSWs have been proposed as immediate and sustained effects of sexual violence among this population ( Shannon et al, 2015 ). In addition, fear of violence may force FSWs into unprotected sexual episodes or certain types of high-risk sexual encounters ( Reeves et al, 2017 ).…”

Section: Introductionmentioning

confidence: 99%

Prevalence and Correlates of Sexual Violence Experienced by Female Sex Workers in Iran: Results from a National HIV Bio-Behavioral Surveillance Survey

Hosseini‐Hooshyar

Mirzazadeh

Karamouzian

et al. 2021

Violence Against Women

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Sexual violence increases the risk of adverse health outcomes among female sex workers (FSWs). Using data from the 2015 national bio-behavioral survey, we explored the experience of sexual violence and its associated factors among Iranian FSWs. Lifetime and recent sexual violence were reported by 40.1% and 16.9%, respectively. History of substance use, ever engaging in anal sex, engaging in group sex within the last year, a high number of clients, recent unstable housing, and incarceration increased the likelihood of experiencing recent sexual violence. These findings underscore the need for community-empowerment and policy-level interventions to address violence among FSWs in Iran.

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The Epidemiology of HIV Among Sex Workers Around the World: Implications for Research, Programmes, and Policy

Viswasam

Rivera²,

Comins

et al. 2021

Sex Work, Health, and Human Rights

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Globally, sex workers of all genders and identities continue to face disproportionately high burdens of HIV, demonstrating the need for programmes better tailoring services to their unmet needs. The reasons for this high burden are complex, intersecting across behavioural, social, and structural realities experienced by sex workers. Here, we build on systematic reviews of HIV among sex workers and case studies rooted in sex workers’ lived experience to describe: (1) the global HIV burden among sex workers; (2) the factors and determinants that influence the HIV burden; (3) intervention coverage and gaps to reduce HIV-related inequities faced by sex workers, over the past decade.Sex workers living with HIV have not benefited enough from significant increases in HIV treatment among the general population. Engagement in this HIV treatment cascade is hindered by structural factors including stigma, migration, policing, criminalisation, and violence, as well as substance use, which present increasingly concurrent risks with HIV among sex workers.Emerging biomedical HIV prevention innovations exist to support the health and human rights of sex workers and reduce onward transmission risk, but persistent data gaps remain, and should be addressed via community-driven implementation research. Epidemiologic research engaging sex workers who are cismen and transgender persons is similarly crucial. Community empowerment approaches have reduced the odds of HIV infection, highlighting the case for greater investments in structural interventions. These investments, combined with filling data gaps and national action towards sex work decriminalisation alongside legal protections, are critical to achieving reductions in sex workers’ HIV burden.

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Gender violence, poverty and HIV infection risk among persons engaged in the sex industry: cross‐national analysis of the political economy of sex markets in 30 European and Central Asian countries

Abstract: Our results are consistent with the theory that reducing poverty and exposure to violence may help reduce HIV infection risk among persons engaged in the sex industry.

Cited by 10 publications

References 35 publications

Population uptake and effectiveness of test‐and‐treat antiretroviral therapy guidelines for preventing the global spread of HIV: an ecological cross‐national analysis

Population uptake and effectiveness of test‐and‐treat antiretroviral therapy guidelines for preventing the global spread of HIV: an ecological cross‐national analysis

Prevalence and Correlates of Sexual Violence Experienced by Female Sex Workers in Iran: Results from a National HIV Bio-Behavioral Surveillance Survey

The Epidemiology of HIV Among Sex Workers Around the World: Implications for Research, Programmes, and Policy

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